Healthcare Provider Details

I. General information

NPI: 1770292278
Provider Name (Legal Business Name): MOHAMED K BARRY, MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2022
Last Update Date: 11/23/2022
Certification Date: 11/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 E 45TH ST FL 17
NEW YORK NY
10017-3303
US

IV. Provider business mailing address

228 E 45TH ST FL 17
NEW YORK NY
10017-3303
US

V. Phone/Fax

Practice location:
  • Phone: 212-651-4338
  • Fax: 212-651-4339
Mailing address:
  • Phone: 212-651-4338
  • Fax: 212-651-4339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MOHAMED BARRY
Title or Position: OWNER
Credential: MD
Phone: 212-651-4338